• Title/Summary/Keyword: renal Failure

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ORTHROGNATHIC SURGERY IN SEVERE CHRONIC RENAL FAILURE PATIENT (중증의 만성신부전 환자에서의 악교정 수술)

  • Shin, Sang-Hun;Kim, Ki-Hyun;Jeung, Suck-Young;Park, Sung-Hwan;Kim, Cheol-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.652-657
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    • 2000
  • The kidneys play a vital role in the maintenance of normal body fluid volumes and in the composition of the extracellular fluid compartments. There are normally more than 2 million functioning glomeruli that regulate total body water and solute concentrations. As renal failure progresses, there is a decrease in the number of functioning nephrons. Chronic renal failure(CRF) is the consequence of a multitude of diseases that cause permanent destruction of the nephron. Azotemia is an elevation in blood urea nitrogen(BUN) and serum creatinine levels subsequent to a decreased glomerular filtration rate(GFR), which results in uremia. This loss of renal function can cause functional and metabolic abnomalities of body. For this problem, oral & maxillofacial surgeons have demanded to routinely treat patients with CRF. However, there has not been a reported case of orthognathic surgery by bilateral sagittal split ramus osteotomy(BSSRO) in patients with CRF, which can cause multiple complications in healthy patients. We report developmental mechanism of complication associated with CRF and preop. and postop. care of orthognathic surgery by BSSRO in Cl III patient with severe chronic renal failure.

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Valve Replacement in an Anuric Patient with Chronic Renal Failure - 1 Case Report - (만성 신부전으로 인한 무뇨증 환자에서의 판막치환술 - 1례 보고 -)

  • Kim, Si-Hoon;Kwack, Moon-Sub;Lee, Sun-Hee;Park, Jae-Kil;Jin, Ung
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.588-590
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    • 1999
  • It is now generalized to perform cardiac surgery in the patients with end-stage renal disease. The growing number of patients with chronic renal failure wake us up to the need to prepare for proper management. There are not only the prevalence of coronary artery disease, but also a great amount of valve dysfunction exist in this group. Peritoneal dialysis may be one of the obstacles for cardiopulmonary bypass but it is not a great hindrance in cardiac surgery with careful preparation and well organized perioperative care. The author has performed mitral valve replacement in a 33-year-old anuric female patient with chronic renal failure and severe mitral insufficiency. Preoperatively, the patient was kept in adequate fluid and electrolyte balance using peritoneal dialysis. Peritoneal dialysis continued and regulated according to the laboratory data in this patient during and after the surgery. She recovered well showing an uneventful course and was discharged on postoperative 1 th day.

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A Case of Henoch-Sch$\"{o}$nlein Purpura with Acute Pancreatitis and Hypovolemic Acute Renal Failure (급성 췌장염과 저혈량성 급성 신부전이 동반된 Henoch-Sch$\"{o}$nlein 자반증 1예)

  • Oh, Ki-Won;Park, Sang-Kyu;Kim, Joon-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.226-229
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    • 2009
  • Gastrointestinal involvement in Henoch-Sch$\"{o}$nlein purpura (HSP) is common. However, both acute pancreatitis and acute renal failure appear to be very rare complications of HSP. We describe a case of HSP with acute pancreatitis and hypovolemic acute renal failure in a 7-year-old girl who presented with a vasculitic purpuric rash involving the lower extremities, abdominal pain, hematochezia, vomiting, and oliguria. Laboratory findings showed increased serum levels of amylase, lipase, and creatinine. An abdominal CT scan revealed diffuse enlargement of the head and body of the pancreas. The patient was successfully managed with conservative treatment, including corticosteroids, and then her pancreatic enzymes and renal function returned to normal. Acute pancreatitis should be differentiated from other causes of acute abdomen in HSP to avoid unnecessary surgery.

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The Experience of Life Reconstruction in Hemodialysis Patients with Chronic Renal Failure (만성신부전 혈액투석 환자의 삶의 재구성 경험에 관한 현상학적 연구)

  • Kim, Yun-Jeong;Kwon, Su-hye
    • Journal of Digital Convergence
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    • v.15 no.9
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    • pp.321-333
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    • 2017
  • This study was a qualitative study using Colaizzi's phenomenological study method to understand the experience of reconstructing life through hemodialysis in chronic renal failure patients and to clarify the meaning of their vivid experience. The participants were eight chronic renal failure patients receiving hemodialysis. Data were collected through individual in - depth interviews with participants. The five categories that were found in the study were 'The beginning of unexpected difficulties', 'Burden of survival brought on by hemodialysis', 'The driving force of recovery', 'Choices and concentration of today in order', ' Every day life which must be woven sincerely'. The results of this study will help clinicians better understand the physical and mental suffering experienced by patients with chronic renal failure receiving hemodialysis and how they are constantly trying to adapt to a changed lifestyle. Also it might provide basic data for the development of efficient nursing intervention for the health management of hemodialysis patients.

Effect of Salviae Radix herb-acupuncture on rabbits with Hg-induced acute renal failure (단삼약침(丹蔘藥鍼)이 급성신부전(急性腎不全) 가토(家兎)의 신세뇨관(腎細尿管)에 미치는 영향(影響))

  • Lim, Chun-Woo;Seo, Jung-Chul;Youn, Hyoun-Min;Jang, Kyung-Jeon;Song, Choon-Ho;Ahn, Chang-Beohm
    • Journal of Acupuncture Research
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    • v.18 no.2
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    • pp.111-122
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    • 2001
  • Objectives ; This study was undertaken to determine if Salviae Radix herb-acupuncture (SRA) exerts protective effect against alterations in membrane transport function in rabbits with mercury chloride (Hg)-induced acute renal failure. Methods and Results ; The administration of Hg at a subcutaneous single dose of 10mg/kg caused a reduction in GFR to 9.4% of the basal value and an increase in fractional Na+ excretion to 10-fold, indicating generation of acute renal failure. When animals were acupunctured with $0.5m{\ell}$ of SRA extract (0.1%) in both sides of Shinsu(BL23) for 7 days prod to Hg administration, such changes were significantly attenuated. The fractional excretion of glucose and phosphate was increased to approximately 132-fold and 7-fold, respectively, in rabbits treated with Hg alone, but the fractional excretion of glucose was increased to 26-fold and that of phosphate was not different from the basal value in SRA-pretreated rabbits. Uptakes of glucose and phosphate in purified isolated brush-border membrane and $Na^+-K^+$-ATPase activity in microsomal fraction were inhibited in rabbits treated with Hg alone, suggesting that impairment in proximal reabsorption of glucose and phosphate is resulted from a direct damage of membrane transport carriers and disruption of the normal $Na^+$ gradient. Conclusions ; Such changes were prevented by SRA. Uptakes of organic ions, PAH and TEA, in renal cortical slices were inhibited by the administration of Hg, which was prevented by SRA. Pretreatment of an antioxidant DPPD attenuated the increase in the fractional excretion of glucose and phosphate induced by the administration of Hg.

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Melittin induces autophagy to alleviate chronic renal failure in 5/6-nephrectomized rats and angiotensin II-induced damage in podocytes

  • Yufan Zhang;Huaping Xu;Hongwei Qiao;Ya Zhao;Minmin Jiang
    • Nutrition Research and Practice
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    • v.18 no.2
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    • pp.210-222
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    • 2024
  • BACKGROUND/OBJECTIVES: Chronic renal failure (CRF) is a complex pathological condition that lacks a cure. Certain Chinese medicines, such as melittin, a major component in bee venom, have shown efficacy in treating CRF patients. On the other hand, the mechanisms underlying the therapeutic effects of melittin are unclear. MATERIALS/METHODS: A 5/6 nephrectomy model (5/6 Nx) of renal failure was established on rats for in vivo assays, and mouse podocyte clone 5 (MPC5) mouse podocyte cells were treated with angiotensin II (AngII) to establish an in vitro podocyte damage model. The 24-h urine protein, serum creatinine, and blood urea nitrogen levels were evaluated after one, 2, and 4 weeks. Hematoxylin and eosin staining, Masson staining, and periodic acid-Schiff staining were used to examine the pathological changes in kidney tissues. A cell counting kit 8 assay was used to assess the cell viability. Reverse transcription polymerase chain reaction and Western blot were used to assess the mRNA and protein levels in the cells, respectively. RESULTS: In the rat 5/6 Nx, melittin reduced the 24-h urinary protein excretion and the serum creatinine and blood urea nitrogen levels. Furthermore, the renal pathology was improved in the melittin-treated 5/6 Nx rats. Melittin promoted podocin, nephrin, Beclin 1, and the LC3II/LC3I ratio and inhibited phosphorylated mammalian target of rapamycin (mTOR)/mTOR in 5/6 Nx-induced rats and AngII-induced MPC5 mouse podocyte cells. Moreover, inhibiting autophagy with 3-MA weakened the effects of melittin on podocin, nephrin, and the LC3II/LC3I ratio in podocytes. CONCLUSION: Melittin may offer protection against kidney injury, probably by regulating podocyte autophagy. These results provide the theoretical basis for applying melittin in CRF therapy.

Serious Bleeding Complication Due to the Use of Low-molecular-weight heparin to treat a Traumatic Patient with Acute Renal Failure (급성신부전이 발생한 중증 외상 환자에서 저분자량헤파린 투여 후 발생한 심각한 출혈 합병증)

  • Kyoung, Kyu-Hyouck;Kim, Woon-Won;Park, Sung-Jin;Kim, Ki-Hoon;Kim, Jin-Soo;Park, Jong-Kwon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.164-167
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    • 2011
  • Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.

Pharmacokinetics of Acebutolol and Diacetolol After Oral Administration of Acebutolol in Rabbits with Folate-Induced Renal Failure (신장장애 가토에서 경구투여시 아세부토롤과 활성대사체인 디아세토롤의 약물동태)

  • Choi, Jun-Shik;Lee, Jin-Hwan
    • Journal of Pharmaceutical Investigation
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    • v.31 no.3
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    • pp.161-165
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    • 2001
  • Acebutolol (ABT) is almost absorbed after oral administration, but its bioavailability is reduced because of considerable first-pass metabolism in the gastrointestine and liver. The purpose of this study was to report the pharmacokinetic changes of ABT and its metabolite, diacetolol (DAT) after oral administration of acebutolol to control rabbits and rabbits with mild and severe folate-induced renal failure (FIRRs). Both of the area under the plasma concentration-time curve $(AUC^0_{\infty})$ of ABT and DAT were significantly increased in mild (p<0.05) and severe FIRRs (p<0.01), but the $AUC^0_{\infty}$ of DAT was more influenced than that of ABT in severe rabbits. There was a good correlation between serum creatinine and both of $AUC^0_{\infty}$ of ABT and DAT. The elimination half-life of ABT and DAT was significantly prolonged in mild (p<0.05) and severe (p<0.01) FIRRs, but the half-life of DAT was more influenced than that of ABT in severe FIRRs. The results suggest that the dosage of acebutolol should be adjusted according to the degree of renal disorder on the base of the serum creatinine concentration.

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Two Cases of $Senior-L\ddot{o}ken$ Syndrome in Siblings (남매에서 발견 된 $Senior-L\ddot{o}ken$ 증후군 2례)

  • Choi, Jung-Youn;Kim, Yong-Jin;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.112-117
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    • 2007
  • Although juvenile nephronophthisis(NPHP) is one of the most frequent genetic causes of chronic renal failure, it has very rarely been reported in Korean children. Most NPHP patients are found to have chronic renal failure, since there are no distinct clinical symptoms for NPHP except polydipsia, polyuria and enuresis in the early stage of disease. Ten percent of NPHP patients manifest retinitis pigmentosa, called $Senior-L\ddot{o}ken$ syndrome. We experienced 2 cases of $Senior-L\ddot{o}ken$ syndrome that occurred in siblings(a 10 year-old boy and a 14-year-old girl) who were diagnosed with Leber's amaurosis. They were found to have severe renal impairment without polydipsia and polyuria. However, no large homogenous deletion of the NPHPI(2q13) gene was not identified in these patients. We report here on these cases and we review the literature to emphasize the association between Leber's amaurosis and the development of chronic renal failure.

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Treatment for acute renal failure occurred by ingestion of grape skins in a dog (개에서 포도껍질 섭취 후 발생한 급성신부전 치료 증례)

  • Oh, Hyun-Wook;Jun, Hyung-Kyou;Choi, Ho-Jung;Lee, Young-Won;Song, Kun-Ho
    • Korean Journal of Veterinary Research
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    • v.48 no.2
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    • pp.215-218
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    • 2008
  • A 2-year-old, female, Maltese dog (3.2 kg of body weight) was referred to the Veterinary Medical Teaching Hospital, Chungnam National University with vomiting, anorexia and depression. Twelve hours prior to the onset of clinical signs, the dog ingested some grape skins (about 60 g). Physical examination at the time of presentation showed peripheral edema and mucous pallor. Blood and blood chemical analysis revealed anemia and moderate azotemia with elevated blood urea nitrogen (107.2 mg/dl), creatinine (6.3 mg/dl) and hyperphosphatemia (11.3 mg/dl). Echogenicity of renal cortex were observred by ultrasonography. The dog was diagnosed as acute renal failure occurred by grape skin toxicosis. The dog was treated with supportive care such as fluid therapy, diuretics (furosemide) and phosphorus binder (almagate). A normal condition of blood and blood chemical findings and clinical signs was observed at five days after treatment, and prognosis is good to date.